Equine 911

Preparation is the key to preventing equine injuries from developing into unfortunate catastrophes. 
by Kristen Weiss, DVM


The balmy spring air breezes through your driver’s side window and you turn up the volume on your favorite CD. You are tense with anticipation of your arrival at your destination, be it your first horse show of the year or a relaxing trail ride with friends. Your thoughts are interrupted by the banging and clunking of your horse in the trailer behind you. You mutter a rhetorical "easy back there" and forget about the incident. As you pull up to your destination you wave to your friends, completely unaware of what awaits you in the trailer? a stressed, sweaty horse with a gaping two-inch wound above his swollen left eye.

Accidents are not predictable. They are not scheduled alongside our farrier visits or training sessions. Although we can make every effort to prevent trauma to our horses, somehow, some way, they still seem to injure themselves. In many situations, these injuries are sustained outside of the comforts of home, perhaps, as in the above example, during transportation to a local horse show or other riding event. Since you never know when or where an injury may occur, you should always be prepared to handle any potential emergencies that could befall your horse.

To properly address emergency situations involving your horse, you will need to recognize abnormalities, educate yourself on the basic first aid required for common equine ailments, and equip your barn and trailer with a complete first aid kit.

Recognize Abnormalities Behavioral Changes

Sometimes injuries are painfully obvious. A deep, bleeding laceration is not likely to escape your attention. But what if the ailment is not so clearly defined? Your horse cannot verbally communicate his problems to you so you must learn to decipher his clues to arrive at the proper conclusion.

Alterations in routine behavior can be extremely useful in evaluating the health of your horse. A horse’s behavior changes as a direct response to altering conditions to which he is exposed. If you have a solid knowledge of your horse’s particular behavior, you will be able to detect even subtle changes. Early intervention is the key to a quick recovery wherever most traumatic injuries and disease processes are concerned. A horse owner who really knows his or her animal will notice even slight behavior changes and be empowered to intervene earlier than a horse owner who is not as astute.

When grooming your horse, study the structure underlying the hair. Make mental notes of where established abnormalities are located. There is no need to concern yourself with scarring from a previous injury. Get a feel for the knobby areas of your horse, such as the bony areas around the face and legs. Sometimes bony protuberances can be misconstrued as swellings, simply because the horse owner does not recognize normal structure. When in doubt, remember that most horses come with two of everything: two eyes, two forelegs, etc. If you are not sure if a structure is normal, check the opposite side to see if the structure in question is present there as well. It is rare for traumatic wounds or swellings to occur symmetrically ? symmetrical "swellings" usually prove to be normal anatomical structures.

Abnormal Vitals

Although normal values have been established and published in veterinary and horse care resources, each horse is an individual. Age, activity, and current health can all affect the vital signs. If you have a baseline of your horse’s individual values prior to an emergency situation, you will be better able to assess possible abnormalities. To establish a baseline, take a series of measurements while your horse is at rest various times on several different days. Avoid recording values taken shortly after exercise or periods of stress. Rates are recorded according to the number of heart beats or breaths that your horse experiences over the period of a single minute. The average of the resting values you collect will provide you with your horse’s normal values. If your horse’s average resting values are outside of the range of normal, schedule an appointment with your veterinarian to ensure that those values are normal for your horse and that there are no underlying causes for the abnormalities you have discovered. If you are unsure of how to properly evaluate your horse’s temperature, pulse and respiration, ask your veterinarian or trusted horseperson for a demonstration.

Common Ailments - Traumatic Wounds - Clinical Signs 
When your horse has sustained a traumatic wound, the most obvious clinical sign would be the presence of a skin defect, usually accompanied by bleeding or hemorrhage. Depending on the location of the wound, other signs you may identify prior to locating the wound itself would be minor to profound swelling of the injured area, matting of hair or accumulation of debris (dirt) overlying the wound, or lameness.

Treatment: Carefully examine the wound for the presence of foreign bodies and debris and determine the extent of damage that has been sustained. In the case of active bleeding, see section on "Hemorrhage." Cleanse all wounds with an antiseptic solution such as chlorhexidine or iodine. Veterinary intervention within the first twenty-four hours is advised for wounds that completely penetrate the skin, as antibiotics may be prescribed to prevent infection or abscessation. If your horse is experiencing pain as a result of the injury, you can administer a veterinary-prescribed non-steroidal anti-inflammatory such as phenylbutazone. Any further wound treatment will be dependent upon the nature of the wound. 

Abrasions: Compared to the gamut of injuries your horse can sustain, abrasions are relatively minor. They do not penetrate the full thickness of the skin and, as a result, require very little medical care. Gentle cleansing with an antiseptic solution and clean water is usually all that is necessary. To prevent dirt from contaminating the site, you can apply a thin layer of antibiotic ointment across the wound. 

Lacerations: A laceration is a slice, cut or tear through the thickness of the skin, revealing structures (such as fat, muscle, tendons or bones) underneath. With such injuries, the wound edges can be manipulated to explore the wound and determine the extent of damage. If the laceration is such that bone or the shiny white tissue of tendons and ligaments is visible, or if the injury involves the eye or a joint, there is no question that you should contact your veterinarian immediately to evaluate the wound and perform the necessary surgical repair. Whenever possible, bandage the wound to protect the exposed tissues and prevent further bleeding. For less invasive wounds, you will need to make a judgment call as to whether or not sutures will be necessary. Consider the depth, location, and characteristics (gaping, tissue flaps) of the wound when making the decision to telephone your vet. 

Punctures: Punctures are penetrating wounds that course full-thickness through the entire skin layer. These injuries carry a great potential for infection and abscess formation as cleansing flushes are difficult and drainage through the small puncture tract is inadequate. Many punctures may still contain the object that caused the injury, so it is important to explore the site whenever possible and remove any foreign material that you find. Flush the site using a syringe to force diluted antiseptic solution into the wound, massaging the affected area to "milk" out any blood clots, dirt or other contaminants. Antibiotics should be administered as soon as possible. Delay in medication may result in the formation of an abscess, which is much more difficult to treat than a simple unorganized infection. In the case of a tragic injury such as impalement into the chest or abdomen, leave the penetrating object in place if it will do no further harm to your horse and call your veterinarian immediately.


• Acute Lameness Clinical Signs: Acute lameness may be the result of a multitude of injuries. The lameness itself may be accompanied by other signs such as bobbing the head or the upward hitch of a hip as the horse abnormally shifts position to bear less weight on the affected limb. In more severe cases, the horse may hold the limb in the air or refuse to stand on it altogether. Injuries you may detect include: sole bruises or punctures, hoof abscesses, obvious trauma such as punctures or lacerations to the tissues of the limbs, abnormal swellings, or fractures. When you examine your horse, feel for areas of heat, swelling or asymmetry, obvious tissue lesions, hemorrhage, and foreign bodies (such as rocks, debris or nails embedded in the sole).

Treatment: If your horse’s limb feels hot or is swollen, cold soak the affected area for twenty minutes, dry thoroughly and, if possible, apply a support bandage. If there is instability or if the limb is non-weight bearing, call the veterinarian immediately. Wrap the leg for support until the veterinarian can arrive. If you locate a penetrating foreign body, such as a nail, leave it in place for the veterinarian to remove if doing so will cause no further damage. If your horse continues to be threatened by the presence of the foreign body, carefully remove it by gently pulling it straight out, but make note of its exact location. Flush the site of the puncture with antiseptic solution and place a protective boot or hoof wrap to prevent introduction of further debris and contamination. If you suspect a hoof injury such as a puncture, abscess or sole bruise, your horse may benefit from a twenty-minute soak in an Epsom salt solution. If your horse is extremely reluctant to bear weight on its forefeet and you palpate heat in the hooves or bounding pulses in the vessels supplying the foot, your horse may be actively foundering. This is an emergency situation and the veterinarian should be called without delay.

In all cases of lameness, restrict activity. Pain may be controlled using phenylbutazone if it has been prescribed by your veterinarian. Minor lameness usually resolves within a few days of stall rest and anti-inflammatory administration, but if it does not, schedule a lameness examination with your veterinarian.

Ocular injury Clinical Signs: A horse that experiences ocular irritation or has sustained an injury such as a corneal laceration or puncture will demonstrate excessive tearing from the affected eye. In addition, some horses demonstrate ocular pain by blinking or rubbing the eye excessively. In the cases of acute injury, tears will be clear or may contain blood (depending on nature of the injury). More chronic conditions may be represented by an opaque yellow or green discharge. Other signs that may be seen include conjunctivitis, swelling of the tissues surrounding the eye, a red discoloration to the sclera, or a white or blue discoloration to the cornea (or eyeball).

Treatment: Carefully evaluate the affected eye, identifying any damage that is present. If you locate a foreign body, gently remove it. If your horse’s eye is too painful to allow safe removal of the object, wait until your veterinarian arrives. The application of topical anesthetics, and perhaps injectable sedatives, may become necessary to properly assess and treat your horse’s eye. If your horse is cooperative, you can flush irritants and foreign bodies from the cornea using a sterile saline flush. Artificial tears or non-steroidal antibiotic ophthalmic ointment will help lubricate the eye and may be soothing after an episode of ocular irritation. If you suspect or have witnessed damage to the cornea, call your veterinarian immediately. Corneal injuries such as lacerations and punctures can progress quickly to ulcers and threaten the health of the affected eye. If the eye merely appears irritated and there is no sign of injury, monitor it closely. If it worsens throughout the day or does not improve in 24 hours, arrange for a veterinary examination.

Hemorrhage Clinical Signs: Hemorrhage is an unavoidable consequence of traumatic injuries. Both the severity of the wound and damage to underlying blood vessels influence the amount of hemorrhage or bleeding your horse will experience. In most cases, blood loss is minimal. There will be instances, however, where a blood vessel becomes lacerated. In these cases, the blood may gush or pulse from the affected vessel and the amount of blood seen can be frightening!

Treatment: If bleeding is seen, apply constant pressure for a minimum of two minutes. The pressure allows the blood to clot, so it is important that you do not relieve the pressure for a full two minutes…no peeking! If blood still gushes or oozes after this time, continue to apply constant pressure until the blood clots. If application of pressure does not resolve the hemorrhage or if you can visualize a pulsing vessel as the source of blood loss, you may carefully clamp a hemostat on the open end of the vessel. You will be required to hold the hemostat or otherwise support it so that its weight does not pull on the tissues of the blood vessel and cause further damage. A hemostat should only be applied in cases of profound hemorrhage. It will prevent further blood loss until your veterinarian can arrive to perform the necessary surgical repairs.

Colic Clinical Signs: The signs of colic vary depending upon the cause and severity of the condition. A colicky horse’s appetite may decrease or become completely absent. He may kick or bite at his abdomen, grind his teeth, swish his tail, sweat in the absence of activity, or lie down with reluctance to rise when encouraged to do so. Some horses experience such pain that they will resort to violent rolling in an attempt to find relief. Measurable signs of pain demonstrated by a horse experiencing a colic episode include a resting heart rate greater than 60 beats per minute and a respiratory rate greater than 30 breaths per minute. Lack of gut sounds ausculted in the hind gut are an ominous sign and require immediate veterinary intervention.

Treatment: At the first signs of colic, you should call your vet immediately. A colic condition can progress from bad to ugly in a short period of time and early veterinary intervention will increase your horse’s chances for a successful recovery. As veterinarians cannot magically appear seconds after being summoned, you will be required to intervene until professional assistance can arrive. Continue to monitor your horse’s vital signs for progression or resolution of abnormalities. Assess the color of your horse’s mucous membranes (gums). They should be medium pink in color, not pale pink, white, purple, blue, or red. Monitor for the presence of gut sounds and passage of feces. When your veterinarian arrives, share this information. It may prove helpful in determining whether and how rapidly the condition is progressing. If your horse is resting fairly quietly, with minimal kicking or pawing, or if he is lying down, but not rolling, you do not need to walk him. On the other hand, if he is rolling or violently kicking at his abdomen, walking may help distract him and prevent him from harming himself. If your veterinarian has previously provided you with a prescribed "emergency" dose of Banamine, verify that you may administer it. It will make your horse more comfortable until more in-depth treatment can be administered. Be certain to inform your veterinarian that you have administered this therapy. If your veterinarian has not provided such medication, nor advised you on proper dosage or administration, do not administer anything. You may induce more harm than good.

First Aid Kit: A carpenter can only be as good as his tools. If you have not taken the time to collect suitable supplies for your first aid kit, you will be unable to attend to your horse during his time of need. Your kit should not only contain the minimum inventory outlined in the list (on the following page), but you should also know how to properly utilize each item in an emergency situation.

Armed with this information, you will be prepared to handle the most common equine emergencies. Know your limits and be sure to call on a professional when you exceed them. If you do not currently possess an equine first aid kit, make it your personal goal to acquire the supplies and create one this week. If you already own a kit, set aside some time to compare its contents to the checklist above and re-supply items as needed. It is my hope that this will be the last time you will find a need to open the container to your first aid supplies until next year’s scheduled inventory check. Be prepared and be safe this summer! 

  • Cell Phone 

  • Flash light 

  • Laminated Vital Signs values Published Ranges: 

  • Temperature 99 - 100.8 ° F 

  • Pulse 28-44 beats/minute 

  • Respiratory rate 8-20 breaths/minute 

  • Watch/timer with a second hand for determining vitals 

  • Laminated phone number sheet (local veterinarians, hospital, emergency contact person) 

  • Non-breakable digital thermometer 

  • Veterinarian-prescribed drugs (Banamine and Phenylbutazone/Bute) 

  • Epsom salts 

  • Hoof pick Hoof nippers/file (in case there is a need to remove shoe) 

  • Hemostat 

  • Extra halter/leadrope 

  • Bandaging supplies: Self-adhesive bandage such as Vetwrap or Coflex Cotton bandage padding +/- quilted leg wrap, Gauze squares small package, 1-2 packages brown gauze, Non-stick absorbent (Telfa) pads (feminine protection pads work well and are inexpensive), 1" Bandaging tape, Roll elastic bandage tape, Duct tape 

  • Cleansing Antiseptic Agents (Chlorhexidine or Iodine solution) 

  • Wound dressing (ie. Nolvassan or nitrofurazone ointment) 

  • Saline solution for flushing deep wounds or ocular wounds 

  • Artificial tears ointment or hydrocortisone-free antibiotic ophthalmic ointment